This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The purpose of this study is to examine the short-term effects of vagus nerve stimulation (VNS) by auricular stimulation (stimulation of the auricular branch of the vagus nerve which innervates the ear) in rheumatoid arthritis (RA). RA is characterized by a chronic systemic inflammation affecting the joints but also carries an increased risk for extra-articular manifestations as well as other organ manifestations such as cardiovascular disease, which significantly contributes to morbidity and mortality in this disorder. Previously, we have studied the relationship between RA and autonomic nervous system function (ANS). Preliminary human data from this study shows that there is an association between ANS dysfunction, measured as heart rate variability and inflammatory markers in RA. Ultimately the goal of this study is to develop new treatment concepts by modulating the ANS in RA with a beneficial effect on disease markers and outcome while minimizing side-effects.